[Value and sequence of the biopsy of the seminal vesicles and laparoscopic pelvic lymphadenectomy in the staging of cancer of the prostate].
OBJECTIVE
To establish the current indication in our milieu of seminal vesicles (s.v.) biopsy and laparoscopic pelvic lymphadenectomy in prostate cancer.


METHODS
The prospective study of s.v. biopsy includes 128 patients. Overall efficacy of the technical procedure, incidence of seminal infiltration in relation to clinical staging, PSA, Gleason or the association of both are all analyzed. The second part of the project involves a retrospective statistical study applied to the lymphadenectomy series over a period of 10 years on 202 cases (69 laparoscopic and 133 open ceiling), analyzing several risk factors for nodular invasion.


RESULTS
Seminal and nodular infiltration was related to clinical stage, PSA and Gleason. PSA > 20 and Gleason > or = 7 is clinically the most useful association for the diagnosis of seminal infiltration. Increased PSA and Gleason involved greater nodular infiltration; the optimal cut-off point is 40 and 7 respectively.


CONCLUSIONS
S.V. biopsy should be performed in T3 stage or in earlier stages with PSA greater or equal to 20 and/or Gleason greater or equal to 7. If biopsy is tumour negative, laparoscopic lymphadenectomy should be performed at T3 stage (regardless of PSA or Gleason), and in < T3 with PSA greater or equal to 40, Gleason greater or equal to 8 and when Gleason is 7 and PSA > 20.
Blas Marín
M
M
Servicio de Urología, Hospital Miguel Severt, Zaragoza.
Allepuz Losa
C
C
Rioja Sanz
C
C
Mínguez
J
J
Gonzalvo
A
A
Plaza
L
L
Rioja Sanz
L A
LA
D000368:Aged; D001706:Biopsy; D006801:Humans; D010535:Laparoscopy; D008197:Lymph Node Excision / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging / Q000379:methods; D011379:Prognosis; D011446:Prospective Studies; D017430:Prostate-Specific Antigen / Q000032:analysis; D011471:Prostatic Neoplasms / Q000737:chemistry / Q000473:pathology*; D012669:Seminal Vesicles / Q000737:chemistry / Q000473:pathology*; D012680:Sensitivity and Specificity
D017430:Prostate-Specific Antigen
Valor y secuencia de la biopsia de vesículas seminales y la linfadenectomía pelviana laparoscopica en el estadiaje del cáncer de próstata.